Gail Eva, Senior Lecturer in Occupational Therapy, Brunel University London, UK, and Deidre Morgan, Lecturer in Palliative and Supportive Services, Flinders University, Adelaide, Australia, explain the background to their longer article published in the May issue of Palliative Medicine.

Deidre Morgan

Gail Eva

“Why are there so few occupational therapists here?” This was the question we found ourselves asking at the EAPC and other multidisciplinary palliative care conferences we attended around 2010. Fellow conference delegates thought the reason was that there were very few occupational therapists working in palliative care in European countries.

As one doctor noted:

“I would like to have occupational therapists in my hospice but there is no service on the ground in my country to point to and say, ‘That’s what OTs in palliative care do,’ so it’s hard to make a case for funding.”

We saw a clear need to raise awareness of the contribution that occupational therapy could make in palliative care. The EAPC Board supported us to set up an Occupational Therapy Task Force, and, taking a lead from the work of task forces in other disciplines, we sought to gain an understanding of the scope of occupational therapy service provision in palliative care in European countries.

In order to achieve this, we carried out a survey of qualified occupational therapists in European countries who were working with palliative care patients. The survey was made available online on the EAPC website, and was publicised via the EAPC and the Council of Occupational Therapists for the European Countries (COTEC). We analysed 237 responses from 21 countries. Approximately half of the respondents were from the UK, where occupational therapy appeared to be significantly better established than in other countries.

Results indicated that the content of occupational therapy services was consistent across Europe. Occupational therapists focused primarily on working directly with patients and families to enable patients to remain active and independent for as long as possible and to remain at home. There was comparatively little involvement in service development and leadership activities, and even less in research.

On the whole, survey respondents reported that where they were able to contribute to patient care, their interventions were valued and welcomed by patients, families and multidisciplinary colleagues. However, they were frustrated by colleagues’very limited understanding of the scope of the occupational therapy role within palliative care, believing that this constrained their ability to be fully and meaningfully involved in patient care.

So, how do we improve patients’ and families’ access to occupational therapy services in palliative care? Occupational therapists themselves can work on communicating their role in effective and creative ways, advocating for service development and participating in research; however, this will only ever be a small part of the solution.

In order to effect meaningful change, those with influential positions in palliative care organisations (service leaders and managers, commissioners, policy makers and researchers) also need to provide support and opportunities for occupational therapists to build, develop, evaluate and expand services using the full range of their expertise, to contribute fully to delivering meaningful outcomes for patients.

Read the full article in Palliative MedicineThis post relates to the article, ‘Mapping the scope of occupational therapy practice in palliative care: A European Association of Palliative Care (EAPC) cross-sectional survey’, by Gail Eva and Deidre Morgan, Palliative Medicine, 2018, Vol. 32(5) 960–968. First published online 24 April 2018. Download the article here.